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Acceptability and feasibility of inter-related activities to improve agency among African district health managers: A four-country study

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dc.contributor.author Fonn, Sharon
dc.contributor.author Ray, Sunanda
dc.contributor.author Couper, Ian
dc.contributor.author Ezeh, Alex
dc.contributor.author Omigbodun, Akinyinka
dc.contributor.author Morhason-Bello, Imran
dc.contributor.author Ng’wena, Gideon
dc.contributor.author Oyungu, Eren
dc.contributor.author Ibingira, Charles
dc.contributor.author Conco, Daphney
dc.contributor.author Blaauw, Duane
dc.date.accessioned 2022-11-25T08:34:31Z
dc.date.available 2022-11-25T08:34:31Z
dc.date.issued 2021-06
dc.identifier.uri http://ir.mu.ac.ke:8080/jspui/handle/123456789/7121
dc.description.abstract District health managers (DHMs) lead and manage Ministry of Health programmes and system performance. We report on the acceptability and feasibility of inter-related activities to increase the agency of DHMs in Kenya, Nigeria, South Africa and Uganda using a cross-sectional rapid appraisal with 372 DHMs employing structured questionnaires. We found differences and similarities between the countries, in particular, who becomes a DHM. The opportunity to provide leadership and effect change and being part of a team were reported as rewarding aspects of DHMs’ work. Demotivating factors included limited resources, bureaucracy, staff shortages, lack of support from leadership and inadequate delegation of authority. District managers ranked the acceptability of the inter-related activities similarly despite differences between contexts. Activities highly ranked by DHMs were to employ someone to support primary care staff to compile and analyse district-level data; to undertake study tours to wellfunctioning districts; and joining an African Regional DHM Association. DHMs rated these activities as feasible to implement. This study confirms that DHMs are in support of a process to promote bottom-up, data-driven, context-specific actions that can promote self-actualisation, recognises the roles DHMs play, provides opportunities for peer learning and can potentially improve quality of care. en_US
dc.publisher Taylor and Francis en_US
dc.subject Health systems en_US
dc.subject District health managemen en_US
dc.subject Sub Saharan Africa en_US
dc.subject Health system stewardship and management en_US
dc.subject Leadership en_US
dc.title Acceptability and feasibility of inter-related activities to improve agency among African district health managers: A four-country study en_US
dc.type Article en_US


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